As the nation's baby boomers age, health-care workers will spend an increasing amount of time treating the elderly. "No single field will experience a shortage of trained professionals as steep as the geriatrics profession," says a spokesman for the American Geriatrics Society.

The job prognosis is good for those with a "special knack" for caring for the elderly, says Jan Shepherd, program director of the sub-acute unit at Anaheim General Hospital in California. "Long-term care is really the place to be, if you're at all suited for that."

The skills you need to get ahead in geriatrics:

1. Patience and compassion. Training across the profession can vary, but patients need empathy. Many elderly patients have lost loved ones and friends and are now facing a decline in their own physical and cognitive functions. The health-care worker's ability to see and respect the whole person is essential.

2. Knowledge of best practices. The elderly encounter a host of challenges as they age. Caring for older patients can mean coping with sleep disturbances, problems with eating or feeding, confusion, evidence of falls and skin breakdown, says Mathy Mezey, director of The John A. Hartford Foundation Institute for Geriatric Nursing at New York University.

Doctors and nurses receive some of this training during their education. Geriatricians complete an additional year of study during a geriatric fellowship; nurses can become accredited in gerontology by taking an exam offered through The American Nurses Credentialing Center.

3. Working with patients' families. Especially in nursing homes, treating the patient also means caring for the family. Geriatrics health-care workers "need to be skilled in how to help families care for frail older adults and in knowing community and institutional resources to refer patients," Mezey says.

4. Stamina. It can take a great deal of energy to carry out the activities of daily living that many elderly patients can no longer perform for themselves. As the growing number of nursing homes adds to the current nursing shortage, certified nursing assistants (CNAs) are doing more of the hands-on nursing like bathing, changing linens, and moving patients from the bed to the wheelchair to the activity room.

5. Assessment skills. Health-care workers caring for the elderly must be trained to assess and manage a complex set of medical conditions. Nursing home administrators assess patient health during enrollment; geriatric nurse practitioners, who provide home care, help family and paid caregivers recognize when the patient's condition is deteriorating.

Stay current in geriatric issues by completing continuing education units (CEUs). Hospitals, federally funded Geriatric Education Centers, professional organizations such as the National Gerontological Nursing Association, and private firms offer courses that allow workers to improve their assessment skills and renew their licenses at the same time.

6. Office skills. Not everyone in geriatrics works directly with the patient. Administration, overseeing staffing, budget, regulatory and quality assurance concerns are key areas to gerontology. Nurses can prepare for management jobs through CEUs that cover everything from computer nursing to working with insurance companies.

7. Knowledge of guidelines. Nursing home administrators, in particular, need to understand and adhere to federal and state regulatory guidelines for the management of elder care facilities. Administrators-in-training can learn what it takes to pass local surveys by apprenticing under a more experienced professional.

8. Marketing. Though caring for the elderly is a calling for some, it also is a business. Nursing homes need to be able to distinguish themselves from the others in the area. Administrators need to be able to communicate not only with emotional family members who may be conflicted about seeking elder care for a loved one, but also with hospital representatives who are seeking placement for stabilized patients.

9. Teaching and supervising. As a growing patient population and the migration of nurses into administration creates a nursing shortage, nursing homes have hired nonprofessional staff to help care for the elderly. Those who have a gift for explaining and motivating are ideally qualified to train new hires.

Community colleges and private organizations have created programs to meet the need for new teachers. The California Association for Health Facilities prepares nurses in that state to teach CNAs. With as little as 36 hours of study, those nurses can be promoted to directors of staff development.

10. Working independently. Although the geriatrics team is expanding, health-care workers must be able to make daily decisions about the care of the elderly. Nurse practitioners care for patients in their homes, program directors assess patients for intake, and nurses start IVs — these and a hundred other duties must be fulfilled every day, at times without supervision.